Chondroid Syringoma Involving the Sub-brow Area

Purpose: Chondroid syringoma of the skin is a rare subcutaneous tumor and localization in the eyelid and orbital region that has rarely been described. We report a case of chondroid syringoma that involved the sub-brow region and was accompanied by hair loss. Case summary: A 57-year-old women presented with a mass on the lateral side of the left sub-brow region which was observed 25 years earlier. The mass, which recurred 2 months after surgery at another hospital through a skin incision was accompanied by an itching sensation. The mass was not tender or ulcerated but was reddish with superficial blood vessels and had a smooth surface with hair loss at the site of the mass. The mass showed high signal intensity on a T2-weighted magnetic resonance image and a round echogenic nodule with an irregular hypoechoic portion was observed on ultrasonography. A full-thickness excision including the adjacent normal tissue of the sub-brow mass and direct closure were subsequently performed. The pathological diagnosis was chondroid syringoma which was revealed as numerous tubular structures with various lumens in a collagenous stroma. Mucinous and fibrous findings were also observed. No recurrence was detected during the first 2 years after surgery. Conclusions: Chondroid syringoma in the eyelid and sub-brow region is uncommon. Complete resection is required to differentiate it from a malignancy and reduce the possibility of recurrence. Incomplete resection or capsular rupture during removal of the tumor could induce recurrence or a malignant change in the tumor.

The Effect of Myrtus communis Aqueous Extract-Containing Gel on Wound Healing in Streptozotocin-Induced Diabetic Rats

Background: : The medicinal plant Myrtus communis L. (Myrtle) has been medicinal properties including antiinflammatory and wound healing in Persian Medicine. Objective: The objective of this study was to explore the wound healing potential of the local application of a gel containing aqueous extract of the plant berry in streptozotocin (STZ)-induced diabetic rats. Methods: Seven days after diabetes establishment, full-thickness excision skin wounds were made in normal and diabetic rats and treated groups received topical application of a gel containing 6% aqueous extract of myrtle berries for 3 weeks. The rate of wound healing and the level of epidermal and dermal maturation in the wound tissue were determined. Results: The results showed that after 3 and 7 days of wound injury, the gel significantly improved wound healing by accelerating epidermal and dermal maturation in diabetic rats with no significant effect in control group. However, the wounds of all groups almost completely healed after 3 weeks. Conclusion: These results demonstrate that aqueous extract of myrtle possesses a definite wound healing potential in diabetic condition. Our present findings may suggest the use of topical myrtle berries aqueous extract gel 6% to treat and manage intractable diabetic wounds.

Cutaneous horn arising from the scrotum

A cutaneous horn, cornu cutaneum, is a hard, conical projection composed of compacted keratin that resembles the horns of animals. They commonly occur on sun-exposed areas, including the head, ears, forearms and hands. Cutaneous horns are extremely rare. Although most are benign in nature, a significant portion may harbour a malignant or pre-malignant lesion, and histopathological analysis of the base of the lesion is imperative to categorise it as one of benign aetiology or one of a more sinister pathology. We present a case of a 46-year-old male who presented with a 2-month history of a painless, firm, rapidly growing conical projection arising from his scrotum. Clinically, a non-tender curved, yellow-brown, horn-like projection was observed arising from the median raphe of his scrotum. With informed consent, a full-thickness excision, with adequate excision of the base of the horn, was performed under local anaesthesia. Macroscopically, the exophytic keratinous lesion was 7.5 cm long and 1.8 cm wide, with the length of the horn far outweighing the width at its base. Histopathological analysis confirmed the presence of a cutaneous horn arising from a condyloma acuminatum as evidenced by a verruciform architecture with tiers of parakeratosis in association with hypergranulosis and koilocytes. No dysplastic or malignant changes were present in the epithelium. According to our knowledge, this is the first case in the English literature of a cutaneous horn arising from the scrotal skin.

Craniofacial Cleft: A Case of Tessier 10 Cleft With a Novel Method to Repair Large Bilateral Colobomas

Objective: To describe a reliable method utilizing large, rotation flaps to reconstruct a number 10 Tessier cleft. Design: This is a descriptive clinical case report. Setting: Pediatric teaching hospital affiliated with a university. Patients, Participants: One participant in this clinical case report. Interventions: Full-thickness excision of the clefted eyelid, brow, and forehead tissue was performed bilaterally to develop medial and lateral eyebrow and forehead flaps. Right: the forehead/brow flap was rotated caudally to reapproximate the eyebrow and an eyelid rotation flap was also used to reapproximate the lid margin. Left: forehead/brow rotation flap allowed realignment of the eyebrow and a series of Z-plasties were used in the eyelid to reapproximate the lid margin and to lengthen the eyelid. Main Outcome Measure(s): Develop and construct a reliable reconstruction with full-eyelid closure and minimal donor site morbidity. Results: Complete eyelid closure bilaterally was achieved intraoperatively, and was maintained at 6-month follow-up with no evidence of ocular pathology. Conclusions: Large, bilateral upper eyelid colobomas require repair to prevent blindness. Although free tarsomarginal grafts and lid-sharing procedures have been described, we demonstrate that large rotation flaps designed along the cleft margin can provide a reliable reconstruction and minimize donor-site morbidity.